Sufferers present process lung transplant must be screened yearly with twin vitality x-ray absorptiometry (DEXA) for the primary two years after the surgical procedure to watch their bone well being, in keeping with outcomes of a latest research.
Researchers led by Ronnie Sebro, MD, PhD, of the Mayo Clinic in Jacksonville, FL, discovered that sufferers expertise a loss in bone mineral density (BMD) after transplant, which places them at greater danger for osteoporosis and fractures.
“Early detection of sufferers with low BMD might enable for intervention and therapy earlier than the event of fractures,” the group wrote. The research was printed November 7 within the Journal of Coronary heart and Lung Transplantation.
Roughly 2,700 lung transplants are carried out yearly within the U.S. A number of elements might contribute to the event of decreased BMD in these sufferers, together with the dearth of bodily exercise as a consequence of preexisting circumstances that led to the transplant, or decreased bodily exercise after the transplant itself, the researchers defined. As well as, immunosuppressive corticosteroids to stop organ rejection have additionally been related to elevated bone loss and decreased BMD over time.
DEXA is the gold normal imaging methodology for screening for low BMD. Thus, on this research, the group aimed to find out the speed of BMD loss in transplant sufferers and the perfect screening interval.
The researchers retrospectively analyzed information from 259 sufferers aged 50 or older who had lung transplants between January 2010 and December 2023. Sufferers needed to have at the very least two DXA scans, one inside a 12 months previous to transplantation, and the opposite after a median of 725 days after transplantation to be included within the research.
DXA scans have been used to acquire areal BMD measurements on the L1-L4 lumbar backbone, whole hip, and femoral neck.
Based on the findings, 65% of the sufferers had osteopenia or osteoporosis earlier than transplant, with males exhibiting greater baseline BMD ranges in contrast with ladies in any respect websites (p < 0.001). The evaluation confirmed that after transplant, the speed of BMD loss was quickest on the femoral neck, however quicker in sufferers with regular BMD at baseline than in sufferers with osteopenia or osteoporosis at baseline previous to transplant (p < 0.001).
“We estimated {that a} important change within the femoral neck BMD could be anticipated to happen inside 409 days and once more at 867 days after lung transplant,” the group wrote.
Finally, the stability between frequent DEXA screening and preventive intervention corresponding to bisphosphonates (osteoporosis drugs) must be rigorously weighed, the group famous.
On one hand, frequent DEXA scans may detect BMD loss early in these sufferers, however at the next monetary price. On the opposite, early preventive measures after transplant would possibly stabilize bone well being and scale back the necessity for fixed monitoring and thus doubtlessly decrease long-term bills, they wrote.
“The best method could possibly be a hybrid mannequin, with focused DEXA screening for high-risk people, mixed with common preventive measures early within the post-transplant section,” the group concluded.
The total research is obtainable right here.
